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HomeMy WebLinkAboutPermit Building 1980-10-9 Address Construction lender c~a ~ I II FORtlATI ON 726-3753 Sq. Ftg. I.jain ~q. Ftg. Access. Sq, Ftg. Other ((Peo $_ rle\~ Add, A 1 ter ReD. --Fence Demo Change/Use Other- - lHH:. I d) 8 S) .D -SJ I I (",00 :2.8'3 -S3'-S- Phone Build Single t )/fi u) I ~ t"j, st1 () 10 I Phone (address) I no. l Address UI:.~J{jH It.All lnameJ Primary I/rc.k, k ~7S Structural ~~~ , Electrical ~~~ I' i1echanical CDIHRft.cTORS (name I C. t;7$,},~ Genera 1 Plumbino Electrical I.techanical /l0. t! (lies. no.) (exo; res) (ohone ~Soc . (e'ni~~ (ohnne nn. I y- ., Z<;(~5~?C. (address) Cc.w. !. ( (1 ics. no.) '- PLUI1BIIlG ELECTRICAL MECHANICAL each FfF I [HARr,F ,.. I ,;,.. .1'1,." - ....,.....:J c.:O~ " I I I I I SERVICES I fI-lARr,r; rm'_ ---+- fu.rnace/burner to .I l..J7"'lJl:')n BTlI's I I-Floor furnace and vent I I Recessed wa 11 - SnnCP hp~t~r ~nrl vpnt I I 1-+ , I l~.cc Nn I Residence of FFF FFF fHAQ(:1= Each single fixture SO, FT. Relocated building (new fix. additional) I HAVE CAREFUllY EXAI'HNED the completed aprlication for I)ermlt, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Ore~lOn pertairiing to the \...ork described herein, and that 110 OCCUPAIKY \.,.i11 be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in comoliance with OP.S 7nl.055 will be used on this nroject. 1!.^;lO(P~:": P";"o) .0&01''''' s -...J.-:',.t..:.., SI,O;iilTVRE ~~ . FO~ OFFICE USE O;iL Y /' Sq. Ftg. 11ain Sq. Ft~. Access Sq, Ftg. Other /1..,00 S.F. Residence (1 bath) Duplex (1 bath) Additional bath Hater service Sewer Storm Sewer Zone I'. - :2.., Fire Zone -. Flood Plain .. //) I ' , BUILDING PERI'IlT Charges an': Surcharges PLUi1BING PERMIT Charges and Surcharges ELECTRICAL PER/lIT Charges and Surcha rges 11ECHAIIl CAL PERMIT Charges and Surcharges New circuits alts. or extensions t-t-. Temporary Construction Change in existing re<;.i dJ'}'lcr I multi~a~ilY, corrrn. or I ; T;1r!u$..n;;l .__0"' Of --==-:-~ Appliance vent <;eoarilte I Stationary evap. cooler ~ I Vent fan with I " c::;."L ~i:,\(I~e dl;C~ ~,'-=' G.oQ I Vent syster.1 apart from I I 'heatina or A.C. I j'lechanical exhaust hond and duct amps. I Cor'lf.l./! ND. FEEDERS I Install/alter/relocate rli<;trih. fpprler<; Of ~ n." amps.! Wood stove/heater ,." "'- ,-.:.;.......'<-J ?or-'"J';;.oo thi s perl'i1it um/O-j-fo Type/Canst. '~jl-,.<l Bedrooms Units Occy Load Oecy Group x '. Value Val ue Value ~.Q ~ / x Stories , , R-:2 x TOTAL VALUATION ":~."'irt'? .c.;:~ .., I 00 Plan Ck, Comm/!nd { \Q. 65%/RldCl Ppr Fpp ---.:2-C:d:-----Pidn Ck. Res ~. 30%/Blda Per Fpe c;'O Ino Fence - - -- - - - --'~I-;" -I Demo : u v !0.....cC) I Sidewalk --------~&;-I AlC Paving ~-----.dd,g9-; Curb Cut r/r:;/ . ~ (; L\9 ,~() PD IIO-to-co Syste~s Development Charqe (1.5~) I I In ,1 ;. ;..':'Uz..-...<~".:,c: 1.l"1, '/0, Total Comb. rermit / :2..~;i =..:; J .... '~........_ I TOTAL ~ DuF._ /. :~#-: , .~ 2- /G::ii~'/Y;.., .<~g.. (~:;;< -.--.- -.--. '~._"-'", - , ~ I p ~ Ill. I I . , I IV, l' , I I I I I I I r .. -~ .. CO;':BINATlO;i .,PPLlCATlGri/PERi-1iT (CAP) I. r PERMIT VALIDATION .... , ./ I!. Applicant to furniSh A. Job ':"ddress B. legal Descrinion 1. exar.;ule- Tax Lot 1/ OJ <;3 2. eX~~jle- lot 1. 31ack 3. 2nd Addition to ~prlngrield Estates C. ria:ne. etc. of o...mer and construction lender O. Energy Sources I. exa:'::Jle- heat/electrical ceilina/or forced 2. e_(c~~!e_ ......aterneHerJelectr~.:al!or solar E. SGuare fOct,1ge or 'Ialuation. etc. - "I. exa~Dle- 1250'sq. foot house. 500 Sq," foot ( 2. eXc~Die- if new project. CheCk-new - if add cheer; acd. etc. F. Bullding pemit infonr.dtion: 1. exa;;]ole - construct single family house \..,it at t.ached garage 2. ey.2::::J}e - rer=:cdel ~xi!:t.;!'1'J adr'~:je i!'"!t~ f;>'~' 3. ~,.cl'lllJi2 - convert single fami'-Iy residence reS~durant (cnange of use) G. Value of work as defined in Section 303 {a} of Stru:tJral Soecialty Code H. OESiGi: ;:::r=.;.; Aim CONTRACTORS To avoid design or construction delays. Build ~ Division Staff must be able to contact aDprop persons regarding design information or job ~ corrections, etc. Abbrev~atea Plu:;;bing, 1"lechanical. & Electrical S, A. ~xeeDt where blank SOaces occur in the deser par~ion of :rle t'lech~nical and Electrical $ch the appjic~nt need fill-in only the i~o. BaxE to the aDpro~riate item(s) to be installed 8. Full ?:u:::bing, Mechanical. and Electric,]] SI are available at the Building Division 1. To conserve space on the permit form th ~ have been abbreviated ~ 2. If the item(:;) to be installed. are not the abbreviated schedules you should cc full schedules C, BUILDIi;G OIVISION STAFF llILL FILL OUT ALL CHARGES Oil THE SCHEDULES D. As noted on the CAP, the label must electrical contractor for signature suoervisor. The general contractor to sign the electrical label. Applicant to sign and date Whenever possible, the initial application wi d wOi'ks(t~E::L oniy. ~':(jere posslbie, Buihiing r 1si will prepare a type \1ritten copy ilnd return ~. applicant at the time the actual permit is i signature. Fees and CharQes 1-" Plan cneck fees are due and payable at the t ,fI'te appllcJ~ion. ~nn no plans will be :rocessed L-- fees are 0,] id. ':'11 other fees dnc cn<.ln;~s Jf"e ch::e LIne payable wn~n the pe~lt is "issued. - ( 100. Lane County r'1ap Referen. CITy OF ~PR'NGF'ElD CIty HolI ' Springfield 0 Department of 'p r~gon OFFICIAL RUbl,e Works ECEIPT ". Date / ") - (, (; No. B ""-',c 19X() , -, Rec'd F I ~ J ' 'n rom '---- (~, f\, hn ((~t}:S -i.. (, "'- ..62..dress 7 '7-27 . tI '-, I . (..- ( ---{'-. '2.iJ.CilQc:e/L'k.<!1 ,-'8 I, - L7Qn0-'~ -::. iliu~ ) B.eceived Fore U~I ) l....C-j'1~-:-~. =.. - '_ L 0'C(;c~- 0 ",- \ r ( r (o~ r:; /1.;.1 \..J -,."-; . . '. 'j i..'f , -- <;'~ Pin nr"" rp I~ ,':,' ~ep -) .10 ~ Do l0, 00 = \ .h 3.(:4 r' = 6 I I 1 I j I J I (. - . -( ( ( be del by hi ~ is no" -- (" I Ii ---- 6tr =------ - ~mOunt -. ( I ~ .. (<to." j Received' 'Z. ~ 'lX 7 ~-- _ -;':~~-L.-Ll~,,__ ( CITY OF SPRINGfiELD (" " '- City Hall Springfield, Oregan Department of Publie Works OFFICIAL RECEIPT ( '!. FOR OFt'U::: USE C.':LY cC roNO. B 54843 ( ( \'iU- ~" , Da'e lJ..."L r 19 ( Rec'd FrO!nf(\Q\J ~ \0 t~ )(J0\.~ UD ( Address L\ ~ 5 ~ (\J&~b\ ld ~ PROJECT CO:lDrTIO:IS TO BE S,~TISfIED BEfO?E 0' ( ( Received For: (. ( ~ ~~~ ffi'{) . 0)( ) ,UU \' ..~) ,~) \- 0 () 0 ~ \ ~, cYJ WI) , tdJ l ; c.J8 ,00 US>') ?<:r< Permit appl icant exempt from registration W' c <. <. \. J'\\O \'t-\ Additional Project Information: PLANS REVIEWED BY: name \, L \, L 5 i 9na tu re ~ =:nt R"eceived ~\ ,~~ ~fJ ~\tu ~ l.. ---- ~\ Xv l \. "' "UTHOlltlZEO SIGN"TUA:E ~..HTON"'U"N."CC ~"'NH"~ " L"Gi:NE 0.. .'.D' ~.5"'. L-- '- .. .".. .........., .. ~.,. ".... .._, '" . I....,. \. \..